Canadian Cancer Trials Group Bulletins

General


Recent Publications

Canadian Cancer Trials Group MA.20 - A Phase III Study of Regional Radiation Therapy in Early Breast Cancer

Whelan TJ, Olivotto IA, Parulekar WR, Ackerman I, Chua BH, Nabid A, Vallis KA, White JR, Rousseau P, Fortin A, Pierce LJ, Manchul L, Chafe S, Nolan MC, Craighead P, Bowen J, McCready DR, Pritchard KI, Gelmon K, Murray Y, Chapman JA, Chen BE, Levine MN. Regional Nodal Irradiation in Early-Stage Breast Cancer. N Engl J Med 373: 307-16, 2015.

Between March 2000 and February 2007, a total of 1832 women with node-positive or high-risk node-negative breast cancer who were treated with breast-conserving surgery and adjuvant systemic therapy were assigned to either the nodal-irradiation group or the control group (916 women in each group). The primary outcome was overall survival. Secondary outcomes were disease-free survival, isolated locoregional disease-free survival, and distant disease-free survival.

The median follow-up was 9.5 years. At the 10-year follow-up, there was no significant between-group difference in survival, with a rate of 82.8% in the nodal-irradiation group and 81.8% in the control group. The rates of disease-free survival were 82.0% in the nodal-irradiation group and 77.0% in the control group.

The researchers, led by Dr. Tim Whelan, Professor at McMaster University in Hamilton and Co-Chair of the Canadian Cancer Trials Group Breast Site Committee, concluded that among women with node-positive or high-risk node-negative breast cancer, the addition of regional nodal irradiation to whole-breast irradiation did not improve overall survival, but reduced the rate of breast-cancer recurrence.

You can read more about these results by using this link ... https://www.ctg.queensu.ca/news/results-ncic-ctg-ma20.

A link to the New England Journal of Medicine publication can be found using this link ... http://dx.doi.org/10.1056/NEJMoa1415340.
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Canadian Cancer Trials Group OV.16 - A Phase III Study of Cisplatin Plus Topotecan Followed by Paciltaxel plus Carboplatin versus Paclitaxel plus Carboplatin as First Line Chemotherapy in Women with Newly Diagnosed Advanced Epithelial Ovarian Cancer

Canadian Cancer Trials Group OV.16 compared the efficacy of cisplatin-topotecan followed by carboplatin-paclitaxel versus carboplatin-paclitaxel in women with newly-diagnosed stage IIB or greater ovarian cancer. There was a significantly lower response rate in the experimental (topotecan) arm compared to standard treatment, and less likelihood of normalized CA125 within the first 3 months. At 43 months follow-up, there were no significant group differences in progression-free survival. There were also significantly more side effects in the experimental arm.

The purpose of the study being reported in this publication was to examine the quality of life endpoints included in the OV.16 trial. The results show that global QoL, physical symptoms, fatigue, and role, emotional, cognitive and social function (all from the EORTC QLQ-C30) significantly improved in both treatment arms, with no significant between-arm differences. Between-group differences in pain, insomnia, and peripheral neuropathy reported while on treatment did not differ at follow-up. Nausea and vomiting improved more with standard treatment both during and after treatment. Body image significantly differed between the groups only at cycle 5 (more deterioration in the standard arm), but group differences disappeared at follow-up. A stratified analysis of global QoL by debulking surgery status found no greater effect indicating that overall improvements in QoL were unrelated to surgical recovery.

As a result, the authors concluded that there was no significant QoL advantage of cisplatin-topotecan. This finding, combined with no progression-free survival conferred by this combination, reaffirms carboplatin-paclitaxel as the standard of care for women with newly-diagnosed ovarian cancer.

Brotto L, Brundage M, Hoskins P, Vergo ed study of sequential cisplatin-topotecan/carboplatin-paclitaxel versus carboplatin-paclitaxel: effects on quality of life (ONLINE). Support Care Cancer 1-9, 2015.

http://rd.springer.com/article/10.1007/s00520-015-2873-8/fulltext.html
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Canadian Cancer Trials Group PR.3 (MRC PR07) - Intergroup Phase III Randomized Trial Comparing Total Androgen Blockade Versus Total Androgen Blockade Plus Pelvic Irradiation In Clinical Adenocarcinoma Of The Prostate

Mason MD, Parulekar WR, Sydes MR, Brundage M, Kirkbride P, Gospodarowicz M, Cowan R, Kostashuk EC, Anderson J, Swanson G, Parmar MKB, Hayter C, Jovic G, Hiltz A, Hetherington J, Sathya J, Barber JBP, McKenzie M, El-Sharkawi S, Souhami L, Hardman PDJ, Chen BE, Warde P. Final Report of the Intergroup Randomized Study of Combined Androgen-Deprivation Therapy Plus Radiotherapy Versus Androgen-Deprivation Therapy Alone in Locally Advanced Prostate Cancer. J Clin Oncol 33: 2143-50, 2015.

The Canadian Cancer Trials Group PR3 (MRC PR07) randomized phase III trial compared androgen-deprivation therapy (ADT) alone versus ADT with radiotherapy (RT) for patients with locally-advanced prostate cancer. The interim analysis at median follow-up of 6.0 years showed that the addition of RT to ADT significantly affected overall survival.

This publication reports the pre-specified final analysis of this randomized trial. One thousand two hundred five patients were randomly assigned between 1995 and 2005, 602 to ADT alone and 603 to ADT+RT. At a median follow-up time of 8 years, 465 patients had died, including 199 patients from prostate cancer. Overall survival was significantly improved in the patients allocated to ADT+RT and deaths from prostate cancer were significantly reduced by the addition of RT to ADT. Therefore, the authors concluded that the previously reported benefit in survival is maintained at a median follow-up of 8 years and firmly establishes the role of RT in the treatment of men with locally advanced prostate cancer.

http://jco.ascopubs.org/content/33/19/2143.full
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Canadian Cancer Trials Group MA.21 - A Phase III Adjuvant Trial of Sequenced EC + Filgrastim + Epoetin Alfa Followed by Paclitaxel Versus Sequenced AC Followed by Paclitaxel Versus CEF as Therapy for Premenopausal Women and Early Postmenopausal Women Who Have Had Potentially Curative Surgery for Node Positive or High Risk Node Negative Breast Cancer

Bartlett JMS, Nielsen TO, Gao D, Gelmon KA, Quintayo MA, Starczynski J, Han L, Burnell MJ, Levine MN, Chen BE, Shepherd LE, Chapman JW. TLE3 is not a predictive biomarker for taxane sensitivity in the Canadian Cancer Trials Group MA.21 clinical trial (ONLINE). Br J Cancer 2015.

http://www.nature.com/bjc/journal/vaop/ncurrent/full/bjc2015271a.html
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Canadian Cancer Trials Group MA.22 - A Phase I/II Study of Increasing Doses of Epirubicin and Docetaxel Plus Pegfilgrastim for Locally Advanced Or Inflammatory Breast Cancer

Parissenti A, Guo B, Pritzker L, Pritzker K, Wang X, Zhu M, Shepherd L, Trudeau M. Tumor RNA disruption predicts survival benefit from breast cancer chemotherapy. Breast Cancer Res Treat 153: 135-44, 2015.

http://rd.springer.com/article/10.1007/s10549-015-3498-9/fulltext.html
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Canadian Cancer Trials Group MA.14 - A Randomized Trial of Antiestrogen Therapy versus Combined Antiestrogen and Octreotide Therapy in the Adjuvant Treatment of Breast Cancer in Post-Menopausal Women

Chapman JA, Costantino J, Dong B, Margolese R, Pritchard K, Shepherd L, Gelmon K, Wolmark N, Pollak M. Octreotide LAR and tamoxifen versus tamoxifen in phase III randomize early breast cancer trials: Canadian Cancer Trials Group MA.14 and NSABP B-29 (ONLINE). Breast Cancer Res Treat 1-8, 2015.

http://rd.springer.com/article/10.1007/s10549-015-3547-4/fulltext.html

Chapman J-AW, Pritchard KI, Goss PE, Ingle JN, Muss HB, Dent SF, Vandenberg TA, Findlay B, Gelmon cancer patients. World Journal of Clinical Oncology 5: 1088-96, 2014.

http://www.wjgnet.com/2218-4333/full/v5/i5/1088.htm
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Canadian Cancer Trials Group LY.12 - A Phase III Study of Gemcitabine, Dexamethasone, and Cisplatin Compared to Dexamethasone, Cytarabine, and Cisplatin Plus/Minus Rituximab [(R) -GDP VS (R) -DHAP] as Salvage Chemotherapy for Patients with Relapsed or Refractory Aggressive Histology Non-Hodgkin's Lymphoma Prior to Autologous Stem Cell Transplant and Followed by Maintenance Rituximab Versus Observation.

Kuruvilla J, Macdonald DA, Kouroukis CT, Cheung M, Olney HJ, Turner AR, Anglin P, Seftel M, Ismail WS, Luminari S, Couban S, Baetz T, Meyer RM, Hay AE, Shepherd L, Djurfeldt MS, Alamoudi S, Chen BE, Crump M. Salvage chemotherapy and autologous stem cell transplantation for transformed indolent lymphoma: a subset analysis of Canadian Cancer Trials Group LY12. Blood 126: 733-8, 2015.

http://www.bloodjournal.org/content/126/6/733